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Reform of the coroner at long last?

There has been chat about this for some time. It’s been in the Queen’s speech for a number of years and draft Bills have gone out for consultation. Perhaps this time the Government is more serious – reform is on the way with the recent publication of the Coroners and Justice Bill 2009.

Previous proposals, which involved spending large sums aimed at providing a well-funded coronial system for the 21st century, appear to have been long forgotten. There is precious little money available to produce what the Ministry of Justice claims will be:

“[a] more effective, transparent and responsive justice and coroner service for victims, witnesses, bereaved families and the wider public."

The main changes

A Chief Coroner to be appointed – to provide national leadership and greater consistency across the service.

A new right of appeal against coroners’ decisions (to the Chief Coroner) is to be made available, and better complaints management.

“A charter for bereaved people” – a general standard of service to be set out, which bereaved people can expect to get.

National standards and guidance, statistics and reports to be available to improve coronial investigations and prevent future deaths.

Better training of coroners and staff.

Better and independent medical scrutiny of deaths not investigated by the coroner.

A system of independent inspection by the Inspectorate of Courts Administration.

The coronial service is to remain funded by the local authority. Coroners are still to be appointed by local authorities but there will be more full-time coroners to preside over larger areas. In future coroners must have a legal qualification on appointment, and medical-only coroners will be phased out. Medical support is promised to include a National Medical Adviser and local medical examiners.

Changes have already been implemented to Rule 43 giving coroners wider powers to issue reports to prevent future deaths. See previous guidance here www.mills-reeve.com.
A new system of death certification is proposed to provide a single system of medical scrutiny of all deaths. A new “medical examiner” to sign off deaths will be appointed, who will be briefed to improve information on deaths to strengthen local clinical governance and public health surveillance.

Comment – effect on the NHS

Most of the changes seem to be neutral for healthcare providers. Coroners might be prompted to provide closer scrutiny and be subject to appeals that may have effects on the detail and information the NHS has to provide. Largely, however, these changes have already taken place over the years with trusts increasingly engaging with the coroner and attending to give evidence at inquests.

The remit of the coroner remains “narrow” and is essentially designed to answer the question as to how a person came about their death. Occasionally inquests will cover an expanded inquiry into the circumstances leading up to a death as required by Article 2 of the Human Rights Act but this will remain the exception rather then the rule. Coroners often allow relations some latitude in questioning now and that is unlikely to change. Pressure groups and lawyers who support families feel that this failure to widen the ambit of the coroner’s inquiry is a cause for grave concern – but, as it stands, its no change for healthcare providers.

There is also criticism by some that there are proposals to hold some inquests affecting national security without a jury and, in such cases, to stop evidence becoming public. Again, while some concerns may or may not be valid, they are unlikely to affect the NHS on a day-to-day basis and the Government argues that an independent coronial system protects the public interest and ensure inquests are compliant with the Human Rights Act.

The system is often criticised because families cannot afford legal support at inquests and they feel the system is against them when they come up against well-funded (comparatively) public bodies who often have solicitors present. Public funding will remain unavailable except in exceptional circumstances. Therefore, again there is no change anticipated for healthcare providers as to when they might face represented families.

Interestingly, the chief coroner is to be appointed from the ranks of High Court judges – much to the displeasure of some coroners who feel that appropriate experience is available from within their own ranks and that an appointment of an “outsider”, who does not properly understand how the coronial system works in practice with all its practical limitations, will not be helpful.

Current status – February 2009

The Bill was introduced into the House of Commons on 14 January and debated at a second reading on 26 January. It is currently undergoing scrutiny in the Public Bill Committee and we will advise and comment further when it becomes law.